Formulary
Desflurane: Indications, Dosing, Side Effects and Interactions
Desflurane clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Desflurane: Indications, Dosing, Side Effects and Interactions
Desflurane clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Induction of anaesthesia (but not recommended)**
- **Adult** (By Inhalation): 4-11 %, to be inhaled through specifically calibrated vaporiser.
**Maintenance of anaesthesia (in nitrous oxide-oxygen)**
- **Adult** (By Inhalation): 2-6 %, to be inhaled through a specifically calibrated vaporiser.
**Maintenance of anaesthesia (in oxygen or oxygen-enriched air)**
- **Adult** (By Inhalation): 2.5-8.5 %, to be inhaled through a specifically calibrated vaporiser.
**Induction of anaesthesia (but not recommended) for desflurane**
- **Child 12-17 years** (By inhalation): 4-11 %, to be inhaled through specifically calibrated vaporiser.
**Maintenance of anaesthesia (in nitrous oxide-oxygen) for desflurane**
- **Neonate** (By inhalation): 2-6 %, to be inhaled through a specifically calibrated vaporiser.
- **Child** (By inhalation): 2-6 %, to be inhaled through a specifically calibrated vaporiser.
**Maintenance of anaesthesia (in oxygen or oxygen-enriched air) for desflurane**
- **Neonate** (By inhalation): 2.5-8.5 %, to be inhaled through a specifically calibrated vaporiser.
- **Child** (By inhalation): 2.5-8.5 %, to be inhaled through a specifically calibrated vaporiser.
Cautions
For all volatile halogenated anaesthetics Can trigger malignant hyperthermia; raised intracranial pressure (can increase cerebrospinal pressure)
Contraindications
For all volatile halogenated anaesthetics Susceptibility to malignant hyperthermia
Side effects
For all volatile halogenated anaesthetics Common or very common Agitation; apnoea; arrhythmias; chills; cough; dizziness; headache; hypersalivation; hypertension; hypotension; nausea; respiratory disorders; vomiting Uncommon Hypoxia Frequency not known Breath holding; cardiac arrest; haemorrhage; hepatic disorders; hyperkalaemia; malignant hyperthermia; QT interval prolongation; rhabdomyolysis; seizure Side-effects For desflurane Common or very common Coagulation disorder; conjunctivitis Uncommon Myalgia; myocardial infarction; myocardial ischaemia; vasodilation Frequency not known Abdominal pain; asthenia; heart failure; hypokalaemia; malaise; metabolic acidosis; pancreatitis acute; shock; skin reactions; ventricular dysfunction; visual acuity decreased
Interactions
**Other interactions (12):**
- Nitrous oxide used concomitantly decreases the MAC of desflurane (Refer Table 1).
- Depolarizing and non-depolarizing Myorelaxants Commonly used muscle relaxants are potentiated by desflurane.
- Anesthetic concentrations of desflurane at equilibrium reduce the ED95 of suxamethonium by approximately 30% and that of atracurium and pancuronium by approximately 50% compared to N 2 O /opioid...
- Table 2 shows the doses of pancuronium, atracurium, suxamethonium and vecuronium required to obtain a 95% depression (ED95) of neuromuscular transmission according to different concentrations of...
- The ED95 of vecuronium is lower than 14%, with desflurane than isoflurane.
- In addition, recovery from neuromuscular blockade is longer with desflurane than isoflurane.
Pregnancy
May depress neonatal respiration if used during delivery.
Breast feeding
Breast-feeding can be resumed as soon as mother has recovered sufficiently from anaesthesia.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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